Individual
SUSAN L EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3901 PARKWAY CIR, SPRINGDALE, AR 72762-6362
(479) 587-1700
(479) 587-1366
Mailing address
3901 PARKWAY CIR, SPRINGDALE, AR 72762-6362
(479) 587-1700
(479) 587-1366
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A005494
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200758080A
—
OK
05
—
225616758
—
AR
05
—
420051541
—
MO
Enumeration date
02/12/2018
Last updated
07/20/2022
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